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<!DOCTYPE html>
<html lang="zh-CN">
<head>
    <meta charset="utf-8">
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="renderer" content="webkit">
    <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no">
    <!-- 上述3个meta标签*必须*放在最前面，任何其他内容都*必须*跟随其后！ -->
    <title>登录</title>

    <!-- Bootstrap -->
    <link href="${domain}/css/bootstrap3/bootstrap.min.css" rel="stylesheet">

    <link href="${domain}/css/public/font-awesome.css" rel="stylesheet">
    <link href="${domain}/css/style.css" rel="stylesheet">
    <link href="${domain}/css/public/function.css" rel="stylesheet">

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    <script src="${domain}/js/model/html5shiv.min.js"></script>
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</head>
<body class="bg-primary">
<div class="container">
    <form class="container-fluid login-wrap bg-white" method="post" action="${domain}/admin/manager/login">
        <div class="page-header text-black">
            <h4>后台登录入口</h4>
            选择问卷类：<select name="type" class="form-control">
            <option value ="first">（1）省、市、县三级医院调查表</option>
            <option value ="second">（2）基层医疗卫生机构（社区卫生服务中心/卫生院）调查表</option>
            <option value="third">（3）村卫生室、社区卫生服务站调查表</option>
            <option value="fourth">（4）门诊部、诊所调查表</option>
            <option value="fifth">（5）省、市、县三级妇幼保健机构调查表</option>
            <option value="sixth">（6）省、市、县三级专科疾病防治院调查表</option>
            <option value="seventh">（7）省、市、县三级疾病预防控制机构调查表</option>
            <option value="eighth">（8）省、市、县三级健康教育机构调查表</option>
            <option value="ninth">（9）省、市两级疗养院调查表</option>
            <option value="tenth">（10）计划生育技术服务机构调查表</option>
            <option value="eleventh">（11）省、市、县三级红十字会调查表</option>
        </select>
            <br/>
            请输入机构名称： <br/><input type="text" class="form-control" name="oName" class="Name" required placeholder="每次输入的机构名称必须一致">
        </div>
        <div class="form-group">
            <div class="input-group input-group-lg padding-bottom15">
                <div class="input-group-addon"><i class="fa fa-user fa-lg"></i></div>
                <input type="text" class="form-control" name="username"
                       value="${debug ? 'admin' : ''}" id="username" placeholder="输入用户名">
            </div>

            <div class="input-group input-group-lg padding-bottom15">
                <div class="input-group-addon"><i class="fa fa-lock fa-lg"></i></div>
                <input type="password" class="form-control" name="password"
                       value="${debug ? 'wenjuan123' : ''}" id="password" placeholder="输入密码">
            </div>

        </div>
        <div class="form-group">
            <div class="col-sm-10 col-sm-6 col-md-4 no-padding">
                <button type="submit" class="btn btn-primary col-md-12 col-xs-12 margin-bottom15">登录</button>
            </div>
        </div>

        <div class="clearfix"></div>
        <div class="padidng-space clearfix"></div>
    </form>
</div>


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<script src="/js/app.js"></script>
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